Individual provider Active NPI

Ifeyinwa Nnajiofor, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Long Island City, NY
National Provider Identifier
1407450133
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
431911 Issued in NY
Practice address
3636 33Rd St Ste 306
Long Island City, NY 11106-2329
Phone
(844) 403-4325
Fax
(424) 625-0010
NPI assigned
Nov 23, 2020
Last updated
May 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 431911 NY Primary

Addresses

Primary practice location

3636 33Rd St Ste 306
Long Island City, NY 11106-2329

Mailing address

10575 Flatlands 2ND St
Brooklyn, NY 11236-3009
Phone (347) 777-8894

Other practice location 1

10575 Flatlands 2nd St
Brooklyn, NY 11236-3009
Phone (347) 777-8894

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210507000733 NY Practitioner - Nurse Practitioner 7911316724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vantage Medical Associates PCGroup PAC ID 0547673816, 84 clinicians

Practice addresses (Care Compare)

1612 Central Ave
Suite 201
Far Rockaway, NY 11691-4002
Phone (516) 792-1600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brookview Medical Associates, PLLC CurrentSince Dec 29, 2022 Accepting new patients

Locations

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1407450133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10575 FLATLANDS 2ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363009",
            "telephone_number": "347-777-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 33RD ST STE 306",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111062329",
            "telephone_number": "844-403-4325",
            "fax_number": "424-625-0010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10575 Flatlands 2nd St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112363009",
            "country_code": "US",
            "telephone_number": "347-777-8894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NNAJIOFOR",
        "first_name": "IFEYINWA",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "431911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.